In October 2018, Florida Clinical Nurse Specialists (CNS) are licensed as Advanced Practice Registered Nurses (APRN). CNSs are now eligible to practice within an advanced practice provider role within a physician supervised protocol. CNSs have always contributed to optimal health outcomes and coordinated cost-saving services and resources. Also, CNSs develop specialized treatment plans after patient examinations and educate patients and families on how to manage their conditions. Healthcare systems have the opportunity to employ CNSs in a provider role including billing for patient services.

The CNS is a graduate of a Master of Science in Nursing (MSN), CNS program and obtains CNS role certification through national accrediting organizations:• American Nursing Certification Corporation (ANCC)• American Association of Critical Care Nurses (AACN)• Oncology Nursing Certification Corporation (ONCC)• National Board Certification Hospice and Palliative Nurse (NBCHPN)

CNSs work in a variety of settings:Hospitals, Home health service, Long-term care facilities, Health centersCNSs work in a variety of populations and specialties:Adult-Gerontology, Pediatrics, Neonatal, Oncology, Critical Care, Diabetes, Pain, etc.

In clinical practice, CNSs work in five major competencies: clinical expertise, consulting, coaching, research, and system leadership. Examples include: evaluating complex patient needs, reviewing and translating new and best-practice evidence, consulting with decision makers to select and allocate health care resources, and mentoring of direct care nurses. This work is done through clinical expertise, analysis of patient data, promoting teamwork, coordinating performance improvement projects and conducting research.

CNSs are in a position to translate the expanded scope of practice to a broader scope of employment such as the advanced practice provider role. As healthcare systems look to CNSs as a resource for promoting quality improvement initiatives and enhancing care through core measures, CNSs may revise their job description to include obtaining and using provider privileges. Generating revenue can increase the demand for CNS positions, attract experienced CNS to Florida, and encourage nurses to choose a CNS career.

What’s next to work in an expanded scope of practice such as the advanced practice provider role? Have a candid discussion with your leadership specifically on expanding your role as an advanced practice provider. Seek out Nurse Practitioner colleagues’ support to become credentialed in your healthcare system. Inquire about enrollment in and obtaining Medicare and Medicaid (CMS) provider numbers and a National Provider Identifier (NPI) number1 for billing. Network with CNS from other states who currently have a revenue-generating practice. Join the National Association of Clinical Nurse Specialists (NACNS) and Florida affiliate (FAOCNS) and FNA CNS Special Interest Group (CNS-SIG). Start the process to maximize the benefits of APRN licensure and provide Floridians with more expert nursing care!